Adolescence is a difficult time for individuals with Type I diabetes. Adolescents typically experience worse metabolic control than do children or adults with diabetes. While worse metabolic control may be due in part to pubertal hormones, adolescents also demonstrate poor self-care behavior. Self-care behavior may deteriorate in part because children are taking responsibility for new aspects of diabetes care during adolescence, and they may not perform these tasks as well or as consistently as their parents did. Past work indicates that more parent responsibility for diabetes care may be related to positive diabetes outcomes, but the results are far from uniform. As adulthood nears, responsibility must eventually shift from the parent to the adolescent with diabetes, but the literature does not identify the best time or technique for doing so. We believe that closer examination of the decisions that guide the transfer of responsibility from parents to children will clarify the relationship between responsibility transfer and outcomes. We also expect that different types of decisions will lead to use of different methods for transferring responsibility to adolescents, which in turn will be linked to diabetes and psychological outcomes.